Low profile adaptor for use with a medical catheter

ABSTRACT

A low profile adaptor for use with a medical catheter. In one embodiment, the adaptor comprises a lower connector portion, an upper connector portion and a valve. The lower connector portion comprises a tubular portion and an annular portion, the annular portion radially surrounding the tubular portion along an intermediate length thereof. A helical thread is formed on the inside surface of the tubular portion. A circular lip projects upwardly a short distance from the top surface of the annular portion. The upper connector portion comprises a tubular section adapted for insertion into the tubular portion of the lower connector portion. An external helical thread is formed on the tubular section of the upper connector portion for mating engagement with the thread on the interior of the tubular portion of the lower connector portion. The upper connector portion also includes an annular base. The top of the base is shaped to include a cavity for receiving the valve, the cavity being in fluid communication with the tubular section. A double-walled circular lip is formed on the bottom of the base, the double-walled lip being sized and shaped to define a groove adapted to matingly receive the lip on the upper connector portion. In use, the lower connector portion is inserted into the end of a catheter, and the tubular section of the upper connector portion is screwed into the tubular portion of the lower connector, with the catheter being ensnared between the lips of the upper and lower connector portions.

BACKGROUND OF THE INVENTION

The present invention relates generally to medical catheters, such asgastrostomy feeding tubes, and relates more particularly to low profileadaptors well-suited for use with medical catheters.

Certain patients are unable to take food and/or medications transorallydue to an inability to swallow. Such an inability to swallow may be dueto a variety of reasons, such as esophageal cancer, neurologicalimpairment and the like. Although the intravenous administration of foodand/or medications to such patients may be a viable short-term approach,it is not well-suited for the long-term. Accordingly, the most commonapproach to the long-term feeding of such patients involves gastrostomy,i.e., the creation of a feeding tract or stoma between the stomach andthe upper abdominal wall. Feeding is then typically performed byadministering food through a feeding tube that has been inserted intothe feeding tract, with the distal end of the feeding tube extendinginto the stomach and being retained therein by an internal anchor orbolster and the proximal end of the feeding tube extending through theabdominal wall.

Although gastrostomies were first performed surgically, mostgastrostomies are now performed using percutaneous endoscopy. In onetype of percutaneous endoscopic gastrostomy (PEG) technique, the distalend of an endoscope is inserted into a patient's mouth and is passedthrough the esophagus into the stomach. After distension of the stomachby inflation, an entry site on the abdomen is identified and an incisioncan be made. A needle, with an outer cannula, is inserted through theentry site across the abdominal and gastric walls. While keeping thecannula in place, the needle is removed, and a flexible wire is passedthrough the cannula into the stomach and into a snare loop extended fromthe distal end of the endoscope. The endoscopic snare loop is then usedto grasp the wire, the cannula is released, and the endoscope and wireare withdrawn through the esophagus and mouth of the patient. A siliconegastrostomy feeding tube, the distal end of which is attached to asilicone, dome-shaped internal bolster, is then secured to the wire andis pulled from its proximal end through the esophagus and into thestomach until the internal bolster engages the stomach wall and thefeeding tube extends through the stomach and abdominal walls, with theproximal end of the feeding tube extending approximately one foot beyondthe abdominal wall. (Over a period of several days followingimplantation of the feeding tube, a stable stoma tract forms around thefeeding tube between the gastric and abdominal walls.)

With the internal bolster in place against the gastric wall, an externalbolster is typically secured to the feeding tube to engage the abdomenso as to prevent longitudinal movement of the feeding tube within thestoma tract. Additionally, a “Y-port” adapter is typically attached tothe proximal end of the feeding tube, the Y-port adapter being adaptedto receive a pair of connector tips through which food and/ormedications may be dispensed. In addition, a detachable locking clip istypically secured to the feeding tube at a point between the externalbolster and the Y-port adapter to prevent gastric fluids from escapingthrough the proximal end of the feeding tube when the feeding tube isnot in use.

Alternative techniques for implanting gastrostomy feeding tubes usingpercutaneous endoscopic gastrostomy are disclosed in U.S. Pat. No.5,112,310, inventor Grobe, which issued May 12, 1992, and U.S. Pat. No.5,167,627, inventors Clegg et al., which issued Dec. 1, 1992, both ofwhich are incorporated herein by reference.

Although gastrostomy feeding tubes of the type described above work wellfor their intended purpose, many active patients find the nearly onefoot length of tubing that extends externally to be unwieldy, difficultto conceal and susceptible to being inadvertently pulled on. As canreadily be appreciated, these conditions are potential sources ofphysical and/or psychological trauma to the patient. Consequently, avariety of low-profile replacement tube assemblies (also referred to inthe art as low-profile replacement PEG devices) have been designed forimplantation within the stoma tract following the removal of aninitially-implanted gastrostomy feeding tube. Such replacementassemblies are referred to as being “low-profile” because they areconsiderably more compact externally than the above-describedinitially-implanted gastrostomy feeding tube assemblies.

An example of a low-profile replacement PEG device is disclosed in U.S.Pat. No. 4,944,732, inventor Russo, which issued Jul. 31, 1990, andwhich is incorporated herein by reference. The low-profile replacementPEG device of said patent comprises a deformable, conical tip portionhaving at least one side aperture therethrough, a tube portion whichextends rearwardly from the tip portion, a fitting portion on the rearend of the tube portion, a removable valve portion in the fittingportion and a flange portion which extends outwardly from the fittingportion. The device is adapted to be installed in a patient so that thetube portion extends through a pre-established stoma with the tipportion located in the patient's stomach and with the fitting portionand the flange portion engaging the skin of the patient adjacent thestoma.

The deformable tip portion of the above-described low-profilereplacement PEG device functions as an internal bolster to anchor itsassociated tube portion in a patient's stomach. To implant and/or removethe aforementioned tube portion from a patient's stomach, an obturatoror similar device is typically inserted through the tube portion and isused to elongate or otherwise deform the tip portion in such a way as topermit the tip portion to fit through the stoma. Removal of theobturator from the tip portion then permits the tip portion to expand toits original shape for anchoring.

Another type of low-profile replacement PEG device uses an inflatableballoon, instead of a deformable tip portion, as an internal bolster toretain the distal end of its associated tube within a patient's stomach.To implant such a device in a patient, the inflatable balloon isdeflated, the distal end of the tube portion is inserted through thestoma, and the balloon is then inflated. To remove the implanted devicefrom a patient, the balloon is deflated and the tube is then withdrawnfrom the stoma.

Further examples of low-profile replacement PEG devices are disclosed inU.S. Pat. No. 4,863,438, inventors Gauderer et al., which issued Sep. 5,1989; and U.S. Pat. No. 5,720,734, inventors Copenhaver et al., whichissued Feb. 24, 1998, both of which are incorporated herein byreference.

Although low-profile replacement PEG devices are less awkward and bulkythan initially-implanted gastrostomy tube assemblies, the use of suchlow-profile replacement PEG devices suffers from its own set ofshortcomings. One such shortcoming is that the implantation of alow-profile replacement PEG device must be preceded by the removal of aninitially-implanted gastrostomy tube. Such removal typically involvespulling on the proximal end of the gastrostomy tube until the internalbolster fails and is drawn through the stoma. As can readily beappreciated, such a procedure can be quite painful to the patient andcan result in damage to the stoma, thereby delaying when the replacementdevice can be implanted.

Another shortcoming of many low-profile replacement PEG devices is thatsuch devices typically do not last as long as initially-implantedgastrostomy tube assemblies (most commonly due to failure of theirinternal anchoring mechanisms or due to clogging or other failure oftheir valve mechanisms) and, therefore, must be replaced more frequentlythan is the case with initially-implanted gastrostomy tube assemblies.

Still another shortcoming of many low-profile replacement PEG devices isthat such devices are typically not adjustable in length. This can beproblematic because there is often an appreciable variation in stomalength from patient to patient. Consequently, it is typically necessary,after removal of the initially-implanted tube and prior to implantationof the replacement device, to measure the length of the stoma and thento select a replacement device having an appropriate length. As canreadily be appreciated, this approach requires that there be madeavailable an inventory of replacement devices of varying lengths.

In order to avoid the aforementioned shortcomings of low-profilereplacement PEG devices while, at the same time, avoiding theabove-described problems associated with having a gastrostomy tubeextend externally for a substantial length, there have recently beendevised a number of adaptors designed for use in converting aninitially-implanted gastrostomy tube into a low-profile PEG device. Onesuch adaptor is disclosed in U.S. Pat. No. 5,549,657, inventors Stern etal., which issued Aug. 27, 1996, and which is incorporated herein byreference. According to said patent, an adaptor is disclosed thereinthat is designed for use with a gastostomy feeding tube which has beeninserted by means of conventional endoscopic procedures and which hasbeen cut to a desired length by a surgeon. The adaptor is said tocomprise an anti-reflux valve assembly having a stem which can beplugged into the open end of the feeding tube. The valve assembly issaid to contain a seal which functions as a one-way valve to preventreflux of gastric contents but which permits the introduction of feedingsolution into the feeding tube. A clamp is placed around the feedingtube and the valve stem and is locked into place to secure the valveassembly to the feeding tube at a location flush with the patient'sskin. A silicone cover is placed around the clamp to protect the patientfrom skin irritation caused by the clamp and also to protect the clampand valve assembly from contaminants.

Although the aforementioned adaptor favorably addresses some of theproblems discussed above, the present inventors have identified certainshortcomings associated therewith. One such shortcoming is that theclamp of said adaptor is quite small and, therefore, difficult tomanipulate. Another shortcoming is that the clamp has a tendency topinch the proximal end of the gastrostomy tube at those points where themale and female sections of the clamp are joined. Such pinching, overtime, has a tendency to cause the tube to tear. In addition, once theclamp is closed, it cannot be re-opened; consequently, one cannot removeand re-attach the valve stem and the clamp from the proximal end of thegastrostomy feeding tube. Accordingly, once the clamp has been closed,one cannot adjust the length of the gastrostomy feeding tube nor can oneclean the valve stem or the proximal end of the feeding tube to removeany accumulated debris therewithin. Moreover, one cannot simplyeliminate the clamp from the aforementioned adaptor since, in theabsence of the clamp, the valve stem, which has a barb-type fitting, canrather easily be pulled out of the feeding tube (i.e., with about a 5pound pulling force).

SUMMARY OF THE INVENTION

It is an object of the present invention to provide a novel low profileadaptor designed for use with a medical catheter, such as a gastrostomyfeeding tube.

It is another object of the present invention to provide a low profileadaptor as described above that overcomes at least some of the problemsdescribed above in connection with existing PEG devices, in general, andlow profile adaptors, in particular.

Therefore, according to one aspect of the invention, there is provided alow profile adaptor well-suited for use with a medical catheter, such asa gastrostomy feeding tube, said adaptor comprising (a) a firstconnector portion, said first connector portion being insertable into afirst end of the medical catheter, said first connector portioncomprising a first tubular member; and (b) a second connector portion,said second connector portion comprising a second tubular member, saidsecond tubular member being directly engageable with said first tubularmember.

In a preferred embodiment, the low profile adaptor comprises a lowerconnector portion, an upper connector portion and a valve. The lowerconnector portion comprises a tubular portion and an annular portion,the annular portion radially surrounding the tubular portion along anintermediate length thereof. A helical thread is formed on the insidesurface of the tubular portion. A circular lip projects upwardly a shortdistance from the top surface of the annular portion. The upperconnector portion comprises a tubular section adapted for insertion intothe tubular portion of the lower connector portion. An external helicalthread is formed on the tubular section of the upper connector portionfor mating engagement with the thread on the interior of the tubularportion of the lower connector portion. The upper connector portion alsoincludes an annular base. The top of the base is shaped to include acavity for receiving the valve, the cavity being in fluid communicationwith the tubular section. A double-walled circular lip is formed on thebottom of the base, the double-walled lip being sized and shaped todefine a groove adapted to matingly receive the lip on the upperconnector portion. In use, the lower connector portion is inserted intothe end of a catheter, and the tubular section of the upper connectorportion is screwed into the tubular portion of the lower connector, withthe catheter being ensnared between the lips of the upper and lowerconnector portions.

As can readily be appreciated, although the adaptor discussed above isdescribed as being a low profile adaptor, such an adaptor is alsosuitable for use with medical catheters, such as gastrostomy feedingtubes, that extend externally for several inches. Accordingly, theadaptors of the present invention are not limited to being low profileadaptors.

According to another aspect of the invention, there is provided thecombination of (a) a first medical catheter, said first medical catheterhaving a first bore; (b) a first connector portion, said first connectorportion being inserted into a first end of said first medical catheterand having a second bore in fluid communication with said first bore;and (c) a second connector portion, said second connector portion beingsecured directly to said first connector portion and having a third borein fluid communication with said second bore, with said first end ofsaid first medical catheter being ensnared between said first connectorportion and said second connector portion.

According to still another aspect of the invention, there is provided anassembly for restricting the diameter of a medical catheter, saidassembly comprising (a) a first member, said first member being providedwith a first transverse opening having a first area and a second area,said first area having a diameter greater than that of said medicalcatheter, said second area having a diameter less than that of saidmedical catheter; and (b) a second member, said second member beingprovided with a second transverse opening having a third area and afourth area, said third area having a diameter greater than that of saidmedical catheter, said fourth area having a diameter less than that ofsaid medical catheter; (c) wherein said first member and said secondmember are positionable relative to one another between a first positionwherein said first area and said third area are aligned and a secondposition wherein said second area and said fourth area are aligned.

For purposes of the present specification and claims, relational termslike “top,” “bottom,” “upper,” and “lower” are used to describe thepresent invention in an context in which the invention is secured to acatheter extending upwardly out of a patient. It is to be understoodthat, by orienting a patient such that the catheter extends outwardly ina direction other than upwardly, the directionality of the inventionwill need to be adjusted accordingly.

Additional objects, as well as features and advantages, of the presentinvention will be set forth in part in the description which follows,and in part will be obvious from the description or may be learned bypractice of the invention. In the description, reference is made to theaccompanying drawings which form a part thereof and in which is shown byway of illustration various embodiments for practicing the invention.The embodiments will be described in sufficient detail to enable thoseskilled in the art to practice the invention, and it is to be understoodthat other embodiments may be utilized and that structural changes maybe made without departing from the scope of the invention. The followingdetailed description is, therefore, not to be taken in a limiting sense,and the scope of the present invention is best defined by the appendedclaims.

BRIEF DESCRIPTION OF THE DRAWINGS

The accompanying drawings, which are hereby incorporated into andconstitute a part of this specification, illustrate various embodimentsof the invention and, together with the description, serve to explainthe principles of the invention. In the drawings wherein like referencenumerals represent like parts:

FIG. 1 is an exploded section view of a first embodiment of a lowprofile adaptor constructed according to the teachings of the presentinvention for use with a gastrostomy feeding tube;

FIG. 2 is a partially exploded section view of the low profile adaptorof FIG. 1, with the lower portion of the connector being shown insertedinto the proximal end of a gastrostomy feeding tube;

FIG. 3 is a section view of the low profile adaptor of FIG. 1, with theproximal end of a gastrostomy feeding tube being shown secured betweenthe fully assembled upper and lower portions of the connector;

FIG. 4 is an exploded section view of a second embodiment of a lowprofile adaptor constructed according to the teachings of the presentinvention for use with a gastrostomy feeding tube;

FIG. 5 is a section view of the low profile adaptor of FIG. 4, with theupper and lower portions of the connector being shown in a partiallyassembled state;

FIG. 6 is a section view of the low profile adaptor of FIG. 4, with theupper and lower portions of the connector being shown in a partiallyassembled state and with the proximal end of a gastrostomy feeding tubebeing shown inserted over the lower connector portion and partiallyinserted into the upper connector portion;

FIG. 7 is a section view of the low profile adaptor of FIG. 4, with theproximal end of a gastrostomy feeding tube being shown secured betweenthe fully assembled upper and lower portions of the connector;

FIG. 8 is a section view of a third embodiment of a low profile adaptorconstructed according to the teachings of the present invention for usewith a gastrostomy feeding tube, the upper and lower portions of theconnector being shown in a partially assembled state;

FIG. 9 is a section view of the low profile adaptor of FIG. 8, with theupper and lower portions of the connector being shown in a partiallyassembled state and with the proximal end of a gastrostomy feeding tubebeing shown inserted over the lower connector portion and partiallyinserted into the upper connector portion;

FIG. 10 is a section view of the low profile adaptor of FIG. 8, with theproximal end of a gastrostomy feeding tube being shown secured betweenthe fully assembled upper and lower portions of the connector;

FIG. 11 is an exploded section view of a fourth embodiment of a lowprofile adaptor constructed according to the teachings of the presentinvention for use with a gastrostomy feeding tube;

FIG. 12 is an exploded section view of a fifth embodiment of a lowprofile adaptor constructed according to the teachings of the presentinvention for use with a gastrostomy feeding tube;

FIG. 13 is an exploded section view of a sixth embodiment of a lowprofile adaptor constructed according to the teachings of the presentinvention for use with a gastrostomy feeding tube;

FIG. 14 is an exploded section view of a seventh embodiment of a lowprofile adaptor constructed according to the teachings of the presentinvention for use with a gastrostomy feeding tube;

FIG. 15 is an exploded section view of an eighth embodiment of a lowprofile adaptor constructed according to the teachings of the presentinvention for use with a gastrostomy feeding tube;

FIG. 16 is a section view of the low profile adaptor of FIG. 15, withthe upper and lower portions of the connector being shown in a partiallyassembled state;

FIG. 17 is a section view of the low profile adaptor of FIG. 15, withthe upper and lower portions of the connector being shown in a partiallyassembled state and with the proximal end of a gastrostomy feeding tubebeing shown inserted over the lower connector portion and partiallyinserted into the upper connector portion;

FIG. 18 is a section view of the low profile adaptor of FIG. 15, withthe proximal end of a gastrostomy feeding tube being shown securedbetween the fully assembled upper and lower portions of the connector;

FIG. 19 is a section view of a ninth embodiment of a low profile adaptorconstructed according to the teachings of the present invention, the lowprofile adaptor being shown attached to the proximal end of agastrostomy feeding tube;

FIG. 20 is a section view of a pair of tubes interconnected using afirst embodiment of a tube connecting assembly constructed according tothe teachings of the present invention;

FIG. 21 is an exploded section view of a tenth embodiment of a lowprofile adaptor constructed according to the teachings of the presentinvention for use with a gastrostomy feeding tube;

FIG. 22 is a section view of the adaptor of FIG. 21, with the upper andlower portions of the adaptor shown in an unassembled state and with theupper portion of the adaptor inserted into the proximal end of agastrostomy feeding tube;

FIG. 23 is an exploded top view of one embodiment of an assemblyconstructed according to the teachings of the present invention forsecuring a barb-type fitting to a medical catheter;

FIG. 24 is a top view of the assembly of FIG. 23 shown in its openposition;

FIG. 25 is a section view of the assembly of FIG. 24 taken along lines1-1;

FIG. 26 is a top view of the assembly of FIG. 23 shown in its closedposition;

FIG. 27 is a section view of the assembly of FIG. 26 taken along lines2-2; and

FIG. 28 is a top view of a modification of the slide shown in FIG. 23.

DETAILED DESCRIPTION OF PREFERRED EMBODIMENTS

Referring now to FIG. 1, there is shown an exploded section view of afirst embodiment of a low profile adaptor constructed according to theteachings of the present invention for use with a gastrostomy feedingtube, said low profile adaptor being identified generally by referencenumeral 11.

Adaptor 11 comprises a lower connector portion 13, an upper connectorportion 15 and a valve 16.

Lower connector portion 13, which is a unitary structure preferably madeof molded medical grade plastic, comprises a tubular portion 17 and anannular portion 19, annular portion 19 radially surrounding tubularportion 17 along an intermediate length thereof. Tubular portion 17 isshaped to include an open top end 21, an open bottom end 23, a circularwall 24, and a longitudinal bore 25. A helical thread 27 is formed onthe inside surface of wall 24 along that portion of its lengthsurrounded by annular portion 19.

Annular portion 19 is shaped to include a top surface 29, a bottomsurface 31, and an outer surface 33. A circular lip 35, which is spacedinwardly from outer surface 33 and is concentrically positioned aroundtubular portion 17, projects upwardly a short distance from top surface29. For reasons to become apparent below, lip 35 is generally triangularin longitudinal cross-section and tapers upwardly in thickness untilcoming to a point 37 at its top.

Upper connector portion 15, which is a unitary structure preferably madeof molded medical grade plastic, comprises a tubular section 53. Tubularsection 53 is shaped to define a circular side wall 55, an open bottomend 57, an open top end 59, and a longitudinal bore 61. The bottomportion 55-1 of circular side wall 55 has a slightly smaller outerdiameter than the remainder of side wall 55. An external helical thread63 is formed on the outer surface of bottom portion 55-1 of side wall55. As will be discussed below in greater detail, tubular section 53 isadapted for insertion through open top end 21 and into tubular portion17 of lower connector portion 13, with thread 63 of bottom portion 55-1matingly engaging thread 27.

Upper connector portion 15 further comprises a base section 71. Basesection 71 is generally annular in shape and includes a top surface 75,a bottom surface 77, and an outer surface 79. A centrally disposedcavity 81, the purpose of which will be described below, is circular inshape and extends downwardly a short distance from top surface 75. Anannular cavity 83, the purpose of which will also be described below,surrounds tubular section 53 and extends upwardly a short distance frombottom surface 77, cavity 83 being smaller in diameter than cavity 81and being separated therefrom by a wall 85. Tubular section 53 extendsdownwardly from wall 85, with open top end 59 of tubular section 53serving as an aperture to interconnect cavity 81 and bore 61.

A double-walled circular lip 93 is formed on bottom surface 77 andextends downwardly therefrom a short distance, lip 93 beingconcentrically spaced inwardly a short distance from outer surface 79.For reasons to become apparent below, lip 93 is sized and shaped todefine a groove 95 that is generally complementary in size and shape tolip 35. In addition, lip 93 tapers downwardly in thickness until comingto a pair of points 94-1 and 94-2 at its bottom.

It should be understood that, although base section 71 is described inthe present embodiment as being annular, base section 71 could take avariety of shapes including, but not limited to, a correspondinglyapertured rectangular or triangular shape. However, regardless of itsshape, base section 71 should be sized so as to be larger than the entrysite of the gastrostomy feeding tube implanted in the patient in orderto prevent the tube and adaptor 11 from being inadvertently drawn intothe body of the patient.

It should also be understood that, although lower connector portion 13and upper connector portion 15 are secured to one another in the presentembodiment by threads 63 and 27, lower connector portion 13 and upperconnector portion 15 could alternatively be secured to one another by asnap fit, a slide fit or other suitable means.

Valve 16, which may be, for example, a silicone gasket of the typedisclosed in U.S. Pat. No. 5,549,657, is seated in cavity 81 and may beheld in place there by a ring (not shown) that is bonded to base section71. Valve 16 is provided with a slit 16-1 that permits a cannula (notshown) to be inserted therethrough so that foods and/or medications maybe delivered to a patient but that also stops the upward flow of gastricfluids from the patient when said cannula is not inserted through slit16-1.

Referring now to FIGS. 2 and 3, there is illustrated the manner in whichadaptor 11 may be secured to the proximal end E of an implantedgastrostomy feeding tube T. First, as seen in FIG. 2, proximal end E oftube T is inserted over the entirety of lower connector portion 13, withbore 25 of lower connector portion 13 being oriented parallel to thelength of tube T. As can readily be appreciated, lower connector portion13 must be appropriately sized relative to tube T so that tube T can bestretched thereover in this manner.

Next, as seen in FIG. 3, bottom portion 55-1 of tubular section 53 isinserted down through end 21 of lower connector portion 13 and is thenscrewed, clockwise, until thread 63 fully engages thread 27. As lowerconnector portion 13 and upper connector portion 15 are initiallybrought together, lip 35 is drawn into groove 95, trapping tube Ttherebetween. The drawing together of lower connector portion 13 andupper connector portion 15 in the aforementioned manner also causes theproximal end E of tube T to be forced up into cavity 83. As can readilybe appreciated, by providing a space into which the proximal end E oftube T can be tucked, cavity 83 permits portions 13 and 15 to be drawncloser together than they otherwise would be permitted to be drawn.Continued clockwise rotation of upper connector portion 15 relative tolower connector portion 13 increases the retentive force of adaptor 11against tube T. Specifically, as upper connector portion 15 is tightenedonto lower connector portion 13, points 37, 94-1 and 94-2 all engagetube T. In addition, as upper connector portion 15 is tightened ontolower connector portion 13, a first right angle pinch point is formed intube T by corner 96 (see FIG. 1) of base section 71, and a second rightangle pinch point is formed in tube T by corner 98 (see FIG. 1) ofintermediate section 17. Each of said two pinch points extends 360degrees around tube T.

With tube T wedged between lower connector portion 13 and upperconnector portion 15 in the above-described manner, adaptor 11 has aretentive force, or grip strength, on tube T of approximately 18 pounds,which is more than three times greater than the force typically exertedby a barb-type fitting.

It should be noted that, to loosen adaptor 11 from a tube T to which ithas been attached or to attach adaptor 11 to an unattached tube T, upperconnector portion 15 must be rotated relative to lower connector portion13. This requires that an operator keep lower connector portion 13stationary while rotating connector portion 15; accordingly, to tightenor to loosen adaptor 11, the operator will typically need to use twohands, one for connector portion 13 and the other for connector portion15. Consequently, because the lower connector portion 13 is nottypically accessible for manipulation when adaptor 11 is installed on apatient in a low profile orientation, but rather, requires that adaptor11 be pulled away from the abdomen to reveal lower connector portion 13,the present invention reduces the likelihood that a patient willinadvertently loosen adaptor 11.

As can be appreciated, adaptor 11 possesses a number of significantfeatures, some of which are not possessed by existing adaptors forgastrostomy feeding tubes. One such feature is that adaptor 11 issecured to the gastrostomy feeding tube in a 360 degree manner. Thisminimizes the chance that an uneven distribution of retentive force willbe applied to the tube, causing the tube to tear. Another such featureis that adaptor 11 is capable of being detached from and thenre-attached to the tube, thereby permitting the length of the tube to beadjusted and/or permitting the adaptor and tube to be cleaned of debris.Still another feature, noted above, is that adaptor 11 retains the tubewith a considerable retentive force. Specifically, adaptor 11 is able towithstand a pulling force of approximately 18 pounds withoutcompromising the quality of the seal between the tube and the adaptor11. Still yet another feature is that adaptor 11 is easy to operate.

Although adaptor 11 is designed primarily for low profile use with agastrostomy feeding tube, it should be understood that adaptor 11 is notlimited to low profile use and could be used with a gastrostomy feedingtube in a high profile arrangement. Moreover, apart from whether adaptoris used in a low profile or high profile context, adaptor 11 is notlimited to use with gastrostomy feeding tubes and may be used withvarious other medical catheters.

Referring now to FIG. 4, there is shown an exploded section view of asecond embodiment of a low profile adaptor constructed according to theteachings of the present invention for use with a gastrostomy feedingtube, said adaptor being identified generally by reference numeral 111.

Adaptor 111 is similar in most respects to adaptor 11, the principaldifferences between adaptor 111 and adaptor 11 being that (i) adaptor111 has a lower profile than does adaptor 11 and (ii) the tubularportion of the lower connector portion of adaptor 111 does not extendupwardly beyond the annular portion of the lower connector portion ofadaptor 111.

More specifically, adaptor 111 comprises a lower connector portion 113,an upper connector portion 115 and a valve 116.

Lower connector portion 113, which is a unitary structure preferablymade of molded medical grade plastic, comprises a tubular section 117.Tubular section 117 is shaped to include an open top end 119, an openbottom end 121, a circular wall 123, and a longitudinal bore 125. Ahelical thread 127, which extends downwardly a short distance from opentop end 119, is formed on the inside surface of wall 123.

Lower connector portion 113 also comprises an annular wall 129, annularwall 129 radially surrounding tubular section 117 at its top end.Annular wall 129 is shaped to include a top surface 131, a bottomsurface 133, and an outer surface 135. A circular lip 137 is formed ontop surface 131 and extends upwardly therefrom a short distance, lip 137being concentrically spaced inwardly a short distance from outer surface135. Lip 137 is generally triangular in longitudinal cross-section andtapers upwardly in thickness until coming to a point 139 at its top.

Upper connector portion 115, which is a unitary structure preferablymade of molded medical grade plastic, comprises a tubular section 153.Tubular section 153 is shaped to define a circular side wall 155, anopen bottom end 157, an open top end 159, and a longitudinal bore 161.The bottom portion 155-1 of circular side wall 155 has a slightlysmaller outer diameter than the remainder of side wall 155. An externalhelical thread 163 is formed on the outer surface of bottom portion155-1 of side wall 155. As will be discussed below in greater detail,tubular section 153 is adapted for insertion into bore 125 of lowerconnector portion 113, with thread 163 of bottom portion 155-1 matinglyengaging thread 127.

Upper connector portion 115 further comprises a base section 171, basesection 171 differing from base section 71 only in its reducedthickness. Accordingly, base section 171 is generally annular in shapeand includes a top surface 175, a bottom surface 177, and an outersurface 179. A centrally disposed cavity 181, the purpose of which willbe described below, is circular in shape and extends downwardly a shortdistance from top surface 175. An annular cavity 183, the purpose ofwhich will also be described below, concentrically surrounds tubularsection 153 and extends upwardly a short distance from bottom surface177, second cavity 183 being smaller in diameter than first cavity 181and being separated therefrom by a wall 185. Tubular section 153 iscentrally disposed within cavity 183 and extends downwardly from wall185, with open top end 159 of tubular section 153 serving as an apertureto interconnect cavity 181 and bore 161.

A double-walled circular lip 193 is formed on bottom surface 177 andextends downwardly therefrom a short distance, lip 193 beingconcentrically spaced inwardly a short distance from outer surface 179.For reasons to become apparent below, lip 193 is sized and shaped todefine a groove 195 that is generally complementary in size and shape tolip 137. In addition, lip 193 tapers downwardly in thickness untilcoming to a pair of points 194-1 and 194-2 at its bottom.

It should be understood that, although base section 171 is described inthe present embodiment as being annular, base section 171 could take avariety of shapes including, but not limited to, a correspondinglyapertured rectangular or triangular shape. However, regardless of itsshape, base section 171 should be sized so as to be larger than theentry site of the gastrostomy feeding tube implanted in the patient inorder to prevent the tube and adaptor 111 from being inadvertently drawninto the body of the patient.

It should also be understood that, although lower connector portion 113and upper connector portion 115 are secured to one another in thepresent embodiment by threads 163 and 127, lower connector portion 113and upper connector portion 115 could alternatively be secured to oneanother by a snap fit, a slide fit or other suitable means.

Valve 116, which may be identical to valve 16 is seated in cavity 181and may be held in place there by a ring (not shown) that is bonded tobase section 171. Valve 116 is provided with a slit 116-1 that permits acannula (not shown) to be inserted therethrough so that foods and/ormedications may be delivered to a patient but that also stops the upwardflow of gastric fluids from the patient when said cannula is notinserted through slit 116-1.

Adaptor 111 is not limited to low profile use nor is it limited to usewith gastrostomy feeding tubes.

Referring now to FIGS. 5 through 7, there is shown the manner in whichadaptor 111 may be attached to the proximal end E of a gastrostomyfeeding tube T. First, as seen in FIG. 5, lower connector portion 113and upper connector portion 115 are partially assembled by screwingtubular member 153 of upper portion 115 partially into bore 125 of lowerconnector portion 113. For reasons to become apparent below, tubularmember 153 is not screwed completely into bore 125, and a space is leftbetween lip 137 of lower connector portion 113 and lip 193 of upperconnector portion 151.

Next, as seen in FIG. 6, the proximal end E of a tube T is inserted overlower connector portion 113 and is passed (preferably as far up aspossible) into cavity 183 of upper connector portion 115. Finally, asseen in FIG. 7, upper connector portion 115 is screwed completely intolower connector portion 113, thereby ensnaring the proximal end E oftube T therebetween. Specifically, as upper connector portion 115 istightened onto lower connector portion 113, tube T is compressed betweenlip 193 of upper connector portion 115 and lip 137 of lower connectorportion 113, with points 139, 194-1 and 194-2 all digging into andengaging tube T. In addition, the above-described tightening together oflower connector portion 113 and upper connector portion 115 results inthe formation of a pair of right angle pinch points in tube T analogousto those formed by adaptor 11.

It should be noted that, by partially assembling adaptor 111 in theabove-described manner before inserting a tube thereover, the handlingof adaptor 111 and the connection of a tube thereto by a physician isfacilitated.

Referring now to FIG. 8, there is shown a section view of a thirdembodiment of a low profile adaptor constructed according to theteachings of the present invention for use with a gastrostomy feedingtube, said adaptor being shown in a partially assembled state and beingidentified generally by reference numeral 211.

Adaptor 211 is similar in most respects to adaptor 111, the principaldifferences between adaptor 211 and adaptor 111 being that adaptor 211does not include an upwardly projecting lip, like lip 137, on its lowerconnector portion 213 or a downwardly projecting lip, like lip 193, onits upper connector portion 215.

The manner in which adaptor 211 may be attached to the proximal end E ofa gastrostomy feeding tube T is shown in FIGS. 8 through 10. First, asshown in FIG. 8, lower connector portion 213 and upper connector portion215 are partially assembled by screwing tubular member 253 of upperportion 215 partially into bore 241 of lower connector portion 213.Next, as seen in FIG. 9, the proximal end E of a tube T is inserted overlower connector portion 213 and is passed (preferably as far up aspossible) into cavity 283 of upper connector portion 215. Next, as seenin FIG. 10, upper connector portion 215 is screwed completely into lowerconnector portion 213, thereby trapping the proximal end E of tube Ttherebetween. Specifically, as upper connector portion 215 is tightenedonto lower connector portion 213, tube T is compressed between lowersurface 277 of upper connector portion and upper surface 219 of lowerconnector portion 213. In addition, the above-described tighteningtogether of lower connector portion 213 and upper connector portion 215results in the formation of a pair of right angle pinch points in tube Tanalogous to those formed by adaptor 111.

Adaptor 211 is not limited to low profile use nor is it limited to usewith gastrostomy feeding tubes.

Referring now to FIG. 11, there is shown an exploded section view of afourth embodiment of a low profile adaptor constructed according to theteachings of the present invention for use with a gastrostomy feedingtube, said low profile adaptor being identified generally by referencenumeral 311.

Adaptor 311 is similar in virtually all respects to adaptor 11, the onlydifference between the two adaptors being that adaptor 311 includes alower connector portion 313, instead of lower connector portion 13.Lower connector portion 313 differs from lower connector portion 13 inthat lower connector portion 313 comprises an annular portion 315,instead of annular portion 19, annular portion 315 having a slopedbottom surface 321 to facilitate the insertion of a gastrostomy feedingtube thereover.

Adaptor 311 is not limited to low profile use nor is it limited to usewith gastrostomy feeding tubes.

Referring now to FIG. 12, there is shown an exploded section view of afifth embodiment of a low profile adaptor constructed according to theteachings of the present invention for use with a gastrostomy feedingtube, said low profile adaptor being identified generally by referencenumeral 411.

Adaptor 411 is similar in many respects to adaptor 11. One differencebetween adaptor 411 and adaptor 11 is that adaptor 411 comprises a lowerconnector portion 413, instead of lower connector portion 13. Lowerconnector portion 413 differs from lower connector portion 13 in thatlower connector portion 413 does not include an annular portion having alip 27, but instead, includes an annular portion 415 having an annularstep 417 projecting upwardly from its top surface 419. Anotherdifference between adaptor 411 and adaptor 11 is that adaptor 411comprises an upper connector portion 421, instead of upper connectorportion 15. Upper connector portion 421 differs from upper connectorportion 15 in that upper connector portion 421 does not include a lip93, but instead, is shaped to define an annular recess 423 adapted toreceive step 417 of lower connector portion 413.

Adaptor 411 is not limited to low profile use nor is it limited to usewith gastrostomy feeding tubes.

Referring now to FIG. 13, there is shown an exploded section view of asixth embodiment of a low profile adaptor constructed according to theteachings of the present invention for use with a gastrostomy feedingtube, said low profile adaptor being identified generally by referencenumeral 511.

Adaptor 511, which is similar in certain respects to adaptor 11,comprises a lower connector portion 513, an upper connector portion 517and valve 16.

Lower connector portion 513, which is a unitary structure preferablymade of molded medical grade plastic, comprises a tubular portion 515,tubular portion 515 being shaped to include an open top end 517, an openbottom end 519, a circular side wall 521 and a longitudinal bore 523. Ahelical thread 525 is formed on the inside surface of wall 521 along anintermediate length thereof.

Lower connector portion 513 also comprises an annular portionsurrounding tubular portion 515 at the top end thereof, said annularportion comprising a circumferential flange 527 formed on the outsidesurface of wall 521 and extending radially outwardly therefrom. Anupwardly extending wall 529 is perpendicularly formed at the peripheryof flange 527. Wall 529, flange 527 and upper section 519 jointly definean annular groove 531.

Upper connector portion 517, which is a unitary structure preferablymade of molded medical grade plastic, comprises an open-ended tubularmember 541 adapted for downward insertion into tubular portion 515through top end 517. The bottom portion of tubular member 541 has aslightly smaller outer diameter than the remainder of tubular member541. An external helical thread 543 is formed on the outer surface ofthe bottom portion of tubular member 541 to matingly engage thread 525.

Upper connector portion 517 further comprises a base section 551. Acircular cavity 553, which is adapted to receive valve 16, is formed inbase section 551 and extends downwardly a short distance from the topsurface thereof. Cavity 553 is in fluid communication with tubularmember 541 through the open top end of tubular member 541. A sleeve 557is formed on base section 551 and extends downwardly a short distancefrom the bottom surface thereof. Sleeve 557 is appropriately dimensionedso that when tubular member 541 is inserted into the tubular member oflower connector portion 513, sleeve 557 is received within groove 531.In this manner, when the proximal end of a tube is inserted over lowerconnector portion 513 and upper connector portion 517 is then screwedinto lower connector portion 513, the proximal end of the tube is forcedup into sleeve 557, with wall 529 and sleeve 557 creating a plurality ofpinch points in the tube.

Adaptor 511 is not limited to low profile use nor is it limited to usewith gastrostomy feeding tubes.

Referring now to FIG. 14, there is shown an exploded section view of aseventh embodiment of a low profile adaptor constructed according to theteachings of the present invention for use with a gastrostomy feedingtube, said low profile adaptor being identified generally by referencenumeral 611.

Adaptor 611 is similar in many respects to adaptor 11, the principaldifference between the two adaptors being that adaptor 611 includes alower connector portion 613, instead of lower connector portion 113.

Lower connector portion 613 comprises an annular base 615, base 615having a top surface 617, a bottom surface 619, an outer wall 621 and acentral bore. The upper portion 623 of said central bore has a greaterdiameter than the lower portion 625 thereof so that, when tubular member153 of upper connector portion 115 is inserted into said bore, bore 161of upper connector portion 115 has a diameter equal to or greater thanthe diameter of lower portion 625. A helical thread 626 is formed on theinside wall of upper portion 623 to matingly engage thread 163. Acircular lip 627, identical in shape to lip 127, is formed on topsurface 617 of base 615.

Lower connector portion 613 also comprises an open-ended tubular member631. Tubular member 631, which extends downwardly from base 615, has abore 633 that is aligned with lower portion 625 of the central bore ofbase 615 and is equal in diameter thereto.

Adaptor 611 is not limited to low profile use nor is it limited to usewith gastrostomy feeding tubes.

Referring now to FIG. 15, there is shown an exploded perspective view ofan eighth embodiment of a low profile adaptor constructed according tothe teachings of the present invention for use with a gastrostomyfeeding tube, said low profile adaptor being identified generally byreference numeral 711.

Adaptor 711 comprises a lower connector portion 713, an upper connectorportion 715 and a valve 16.

Lower connector portion 713, which is a unitary structure preferablymade of molded medical grade plastic, comprises a tubular portion 714having an open top end 717, an open bottom end 719, a circular wall 721and a longitudinal bore 723. A helical thread 725 is externally providedon wall 721 and extends downwardly a short distance from top end 717.

Lower connector portion 713 also comprises an annular flange 727, flange727 surrounding tubular portion 714 just below the bottom of thread 725.Flange 727 is shaped to include a horizontal top surface 729, a verticalside surface 731 and a sloped bottom surface 732.

Upper connector portion 715, which is a unitary structure preferablymade of molded medical grade plastic, comprises a top surface 733, abottom surface 735, an outer surface 737 and a central bore. Saidcentral bore is shaped to include a top section 741, an intermediatesection 743, and a lower section 745. Top section 741 is appropriatelydimensioned to receive valve 16. Intermediate section 743 and lowersection 745 are appropriately dimensioned to receive the top portion oflower connector portion 713, and a helical thread 747 is formed on theinside surface of intermediate section 743 to matingly engage thread725. An annular recess 749 is provided in upper connector portion 715 toreceive the proximal end of a tube.

It should be noted that one distinction between adaptor 711 and adaptor11 is that, whereas adaptor 11 comprises a lower connector portion 13having a female thread 31 and an upper connector portion 15 having amale thread 63, adaptor 711 comprises a lower connector portion 713having a male thread 725 and an upper connector portion 715 having afemale thread 747.

Referring now to FIGS. 16 through 18, there is shown the manner in whichadaptor 711 may be secured to the proximal end E of a gastrostomyfeeding tube T. First, as seen in FIG. 16, lower connector portion 713is partially inserted and screwed into upper connector portion 715.Next, as seen in FIG. 17, the proximal end E of a tube T is insertedover lower connector portion 715 and is fed into recess 749 of upperconnector portion 715. Lastly, as seen in FIG. 18, lower connectorportion 713 is fully screwed into upper connector portion 715, ensnaringthe proximal end E of tube T therebetween.

Adaptor 711 is not limited to low profile use nor is it limited to usewith gastrostomy feeding tubes.

Referring now to FIG. 19, there is shown a section view of a ninthembodiment of a low profile adaptor constructed according to theteachings of the present invention, said low profile adaptor being shownattached to the proximal end E of a gastrostomy feeding tube T and beingrepresented generally by reference numeral 771.

Adaptor 771 comprises a lower connector portion 773 and an upperconnector portion 775. Lower connector portion 773 is identical to lowerconnector portion 313 of adaptor 311. Upper connector portion 775 issimilar in certain respects to upper connector portion 15 of adaptor311, upper connector portion 775 principally differing from upperconnector portion 15 in that upper connector portion 775 is sized andshaped to receive a medical luer. Upper connector portion 775additionally differs from upper connector portion 15 in that upperconnector portion 775 is not shaped to include a cavity for receiving avalve 16.

Adaptor 771 is not limited to low profile use nor is it limited to usewith gastrostomy feeding tubes.

Referring now to FIG. 20, there are shown tubes T_(i) and T₂ whose endse₁ and e₂, respectively, are interconnected using a first embodiment ofa tube connecting assembly constructed according to the teachings of thepresent invention, said tube connecting assembly being representedgenerally by reference numeral 781.

Assembly 781 comprises first and second connector portions 781-1 and781-2, respectively, first and second connector portions 781-1 and 781-2being identical to one another and to lower connector portion 13 ofadaptor 11. As can be seen in FIG. 20, when interconnecting tubes T₁ andT₂, end e₁ of tube T₁ is inserted over first connector portion 781-1 andend e₂ of tube T₂ is inserted over second connector portion 781-2.

Assembly 781 further comprises a third connector portion 783. Thirdconnector portion 783, which is a unitary structure preferably made ofmolded medical grade plastic, comprises a generally annular base 785formed around a tubular member having an externally threaded bottom end787 adapted to be screwed into bore 25-1 of first connector portion781-1 and an externally threaded top end 789 adapted to be screwed intobore 25-2 of second connector portion 781-2. A first annular cavity791-1 surrounds the tubular member and extends upwardly from the bottomof base 785, cavity 791-1 being adapted to receive end e₁ of tube t₁. Asecond annular cavity 791-2 surrounds the tubular member and extendsdownwardly from the top of base 785, cavity 791-2 being adapted toreceive end e₂ of tube t₂. A first double walled lip 793-1 is formed onthe bottom surface of base 785, and a second double walled lip 793-2 isformed on the top surface of base 785. Lips 793-1 and 793-2 areidentical to lip 93 of adaptor 11, lip 793-1 being adapted to receivelip 27-1 of first connector portion 781-1 and lip 793-2 being adapted toreceive lip 27-2 of second connector portion 781-2.

Referring now to FIGS. 21 and 22, there is shown a tenth embodiment of alow profile adaptor constructed according to the teachings of thepresent invention, said low profile adaptor being shown attached to theproximal end E of a gastrostomy feeding tube T and being representedgenerally by reference numeral 811.

Adaptor 811 comprises a lower connector portion 813 and an upperconnector portion 815.

Lower connector portion 813, which is a unitary structure preferablymade of molded medical grade plastic, comprises an annular base section816 having a top surface 817, a bottom surface 819, an outer surface 821and a central bore 823. Bore 823 is appropriately dimensioned to permita tube T to pass therethrough. Lower connector portion 813 furthercomprises a tubular member 825 extending upwardly from top surface 817,tubular member 825 being concentrically positioned around bore 823.Member 825 has an open top end 827 and a bore 829. A helical thread 831is formed on the inside surface of member 825.

Upper connector portion 815, which is a unitary structure preferablymade of molded medical grade plastic, is a generally annular membershaped to include a longitudinal bore 839 and a plurality of steps 841,843, 845 and 847 of decreasing diameter from top to bottom. Step 841 issized to rest upon top end 827 of tubular member 825 when upperconnector portion 815 and lower connector portion 813 are assembled. Ahelical thread 849 is formed on the outside surface of step 843 formatingly engaging thread 831 when upper connector portion 815 and lowerconnector portions 813 are assembled. Step 845 is sized to rest uponbottom end 850 of tubular member 825 when upper connector portion 815and lower connector portion 813 are assembled. Step 847 is sized forinsertion into the proximal end E of a tube T.

In use, the proximal end E of a tube T is inserted up through bores 823and 829. Step 847 is then inserted down into the proximal end of tube T.Upper connector portion 815 is then screwed down into lower connectorportion 813 by matingly engaging threads 849 and 831.

Adaptor 811 is not limited to low profile use nor is it limited to usewith gastrostomy feeding tubes.

Referring now to FIGS. 23 through 27, there are shown various views ofan assembly for restricting the diameter of a medical catheter, forexample, to tighten said catheter around a barb fitting or the likeinserted thereinto, the assembly being constructed according to theteachings of the present invention and being identified generally byreference numeral 911.

Assembly 911 comprises a housing 913 and a slide 915, slide 915 beingslidably mounted within housing 913.

Housing 913, which is a unitary structure preferably made of moldedmedical grade plastic, is a generally rectangular, hollow member havinga top wall 917, a bottom wall 919, a pair of side walls 921-1 and 921-2,and a pair of open ends. A first opening 923 is formed on top wall 917,and a second opening 925, which is identical to first opening 923 andaligned therewith, is formed on bottom wall 919. Each of first opening923 and second opening 925 comprises a first area 931 of comparativelygreater diameter and a second area 933 of comparatively lesser diameter.For reasons to become apparent below, area 931 has a diameter greaterthan that of the medical catheter with which assembly 911 is intended tobe used whereas area 933 has a diameter smaller than that of the medicalcatheter.

Slide 915, which is a unitary structure preferably made of moldedmedical grade plastic, is a generally rectangular plate. An opening 935comprising a first area 937 of comparatively greater diameter and asecond area 939 of comparatively lesser diameter is provided in slide915, opening 935 being a mirror image of openings 923 and 925.

In use, slide 915 is first positioned within housing 913 so that area937 of opening 935 is aligned with area 931 of openings 923 and 925. Ascan be seen in FIGS. 24 and 25, this positioning results in theformation of a transverse hole having the diameter of area 931. Withassembly 911 thus positioned, the proximal end of a medical catheter isthen inserted up through openings 925, 935 and 923, respectively. Abarb-type fitting is then inserted into the proximal end of the medicalcatheter. Assembly 911 is then moved proximally until the distal end ofthe barb-type fitting and the proximal end of the medical catheter arepositioned within openings 925, 935 and 923. Slide 915 is then moved sothat area 939 of opening 935 is aligned with area 933 of openings 923and 925. As can be seen in FIGS. 26 and 27, this results in theformation of a transverse hole having the diameter of area 933, causingassembly 911 to pinch the end of the catheter against the barb-typefitting.

An alternative slide 971 adapted for use with housing 913 is shown inFIG. 28. Slide 971 differs from slide 915 in that slide 971 has anopening 973 in which there is a smoother transition from larger area 975to smaller area 977 than is the case with opening 935 of slide 915.(This smoother transition can also be applied to the shape of openings923 and 925 in housing 913.) Slide 971 also differs from slide 915 inthat slide 971 additionally includes an arcuate wall 981 that extendsfrom the top and bottom surfaces of slide 971 so that, when assembly 11is in its closed position, slide 971 engages the tube at the same levelthat housing 913 does.

As can readily be appreciated, housing 913 could be modified toeliminate one or more of walls 917, 921-1 and 921-2.

The embodiments of the present invention described above are intended tobe merely exemplary and those skilled in the art shall be able to makenumerous variations and modifications to it without departing from thespirit of the present invention. All such variations and modificationsare intended to be within the scope of the present invention as definedin the appended claims.

1. An adaptor well-suited for use with a medical catheter, said adaptorcomprising: (a) a first connector portion, said first connector portionbeing insertable into a first end of the medical catheter, said firstconnector portion comprising a first tubular member; and (b) a secondconnector portion, said second connector portion comprising a secondtubular member, said second tubular member being directly engageablewith said first tubular member.
 2. The adaptor as claimed in claim 1wherein said first and second tubular members are threadinglyengageable.
 3. The adaptor as claimed in claim 2 wherein said firsttubular member is internally threaded and wherein said second tubularmember is externally threaded.
 4. The adaptor as claimed in claim 2wherein said first tubular member is externally threaded and whereinsaid second tubular member is internally threaded.
 5. The adaptor asclaimed in claim 1 wherein said first and second connector portionsfurther comprise complementary means for ensnaring the medical cathetertherebetween.
 6. The adaptor as claimed in claim 5 wherein saidcomplementary means comprises a circular lip formed on said firstconnector portion and a complementary groove formed in said secondconnector portion.
 7. The adaptor as claimed in claim 6 wherein saidcircular lip is triangular in cross-section.
 8. The adaptor as claimedin claim 5 wherein said complementary means comprises an annular stepformed on said first connector portion and a complementary cavity formedin said second connector portion.
 9. The adaptor as claimed in claim 5wherein said complementary means comprises an annular sleeve formed onsaid second connector portion and a complementary groove formed on saidfirst connector portion.
 10. The adaptor as claimed in claim 5 whereinsaid complementary means comprises an annular flange formed on saidfirst connector portion and a complementary cavity formed in said secondconnector portion.
 11. The adaptor as claimed in claim 1 wherein saidsecond connector portion further comprises a first cavity in fluidcommunication with said second tubular member and wherein said adaptorfurther comprises a gasket-type valve seated in said first cavity. 12.The adaptor as claimed in claim 1 wherein said second connector portionis dimensioned to receive a medical luer.
 13. The combination of (a) afirst medical catheter, said first medical catheter having a first bore;(b) a first connector portion, said first connector portion beinginserted into a first end of said first medical catheter and having asecond bore in fluid communication with said first bore; and (c) asecond connector portion, said second connector portion being secureddirectly to said first connector portion and having a third bore influid communication with said second bore, with said first end of saidfirst medical catheter being ensnared between said first connectorportion and said second connector portion.
 14. The combination asclaimed in claim 13 wherein said first connector portion comprises afirst tubular portion and a first annular portion, said first annularportion surrounding said first tubular portion, said second bore beingpresent within said first tubular portion.
 15. The combination asclaimed in claim 14 wherein said second connector portion comprises asecond tubular portion and a second annular portion, said second annularportion surrounding said second tubular portion, said third bore beingpresent within said second tubular portion.
 16. The combination asclaimed in claim 15 wherein said second tubular portion is inserted intosaid first tubular portion and is secured directly thereto by the matingengagement of a first thread on the exterior of said second tubularportion with a second thread on the interior of said first tubularportion.
 17. The combination as claimed in claim 15 wherein said firstmedical catheter is ensnared between a projection formed on said firstannular portion and a complementary shape formed in said second annularportion.
 18. The combination as claimed in claim 17 wherein saidprojection is a circular lip.
 19. The combination as claimed in claim 17wherein said projection is a annular step.
 20. The combination asclaimed in claim 17 wherein said projection is an annular flange. 21.The combination as claimed in claim 15 wherein said second annularportion is shaped to include a cavity for receiving an end of the firstmedical catheter.
 22. The combination as claimed in claim 15 whereinsaid second annular portion is shaped to include a cavity in fluidcommunication with said second tubular portion, said combination furthercomprising a gasket-type valve seated in said cavity.
 23. Thecombination as claimed in claim 14 wherein said first annular portionhas a sloped bottom surface to facilitate insertion of said firstconnector portion into said first medical catheter.
 24. The combinationas claimed in claim 13 further comprising a second medical catheter anda third connector portion, said second medical catheter having a fourthbore, said third connector portion being inserted into said secondmedical catheter and secured directly to said second connector portion,said third connector portion having a fifth bore in fluid communicationwith both said fourth bore and said third bore, with said second medicalcatheter being ensnared between said second connector portion and saidthird connector portion.
 25. The combination as claimed in claim 14wherein said first tubular portion is inserted into said third bore ofsaid second connector portion and is secured directly thereto by themating engagement of a first thread on the exterior of said firsttubular portion with a second thread within said third bore.
 26. Thecombination as claimed in claim 13 wherein said medical catheter is agastrostomy feeding tube having an internal bolster secured to a secondend thereof.
 27. An assembly for restricting the diameter of a medicalcatheter, said assembly comprising: (a) a first member, said firstmember being provided with a first transverse opening having a firstarea and a second area, said first area having a diameter greater thanthat of said medical catheter, said second area having a diameter lessthan that of said medical catheter; and (b) a second member, said secondmember being provided with a second transverse opening having a thirdarea and a fourth area, said third area having a diameter greater thanthat of said medical catheter, said fourth area having a diameter lessthan that of said medical catheter; (c) wherein said first member andsaid second member are positionable relative to one another between afirst position wherein said first area and said third area are alignedand a second position wherein said second area and said fourth area arealigned.
 28. The assembly as claimed in claim 27 wherein said firstmember is a housing and said second member is a slide slidably mountedwithin said housing.
 29. The assembly as claimed in claim 28 whereinsaid housing is a generally rectangular hollow structure comprising atop wall, a bottom wall and a pair of side walls.
 30. The combination ofthe assembly of claim 27, a medical catheter having a diameter less thansaid first and third areas and greater than said second and fourthareas, and a barb fitting inserted into an end of said medical catheter,said barb fitting having a diameter less than said first and third areasand greater than said second and fourth areas.